Pharmacy

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Pharmacy

Zenith provides pharmacy benefits through a pharmacy benefit management (PBM) program to help injured employees obtain covered prescription medications with no out-of-pocket expense. Zenith network and panel providers are expected to comply with all applicable prescription dispensing laws and regulations and direct injured employees to pharmacies participating in our PBM program whenever possible.

California ZPN* Pharmacy Lookup

Zenith Insurance Company (“Zenith”) provides pharmaceutical services to injured employees through the Zenith Pharmacy Network (ZPN). Injured employees are required to obtain medications, including compounded medications, from a pharmacy participating in the ZPN. All treatment must comply with Medical Treatment Utilization Schedule (MTUS), including the MTUS Drug Formulary. We do not provide reimbursement for medications dispensed at a provider’s office unless the medication is for a medically necessary intrathecal pain pump (including refill), or is an antiviral or antibiotic.

Bills for medically necessary intrathecal pain pumps, antivirals, and antibiotics that are dispensed from a provider’s office will be reimbursed at the provider’s contracted rate or pursuant to the official medical fee schedule, whichever is applicable.

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*The Zenith Pharmacy Network (ZPN) was established pursuant to Labor Code 4600.2(a). “Zenith” means either Zenith Insurance Company or ZNAT Insurance Company, whichever provides the coverage for the injured employee. If neither Zenith nor ZNAT are the underwriting carrier, then Zenith is acting as the claims administrator only.

Non-California PBM Pharmacy Lookup

When prescribing medication, please provide the injured employee with a written prescription, use an e-prescribing service, or call the prescription into the participating pharmacy selected by the injured employee.

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